A score‐based method for quality control of fetal hard palate assessment during routine second‐trimester ultrasound examination

Fuchs, Florent; Burlat, Julie; Grosjean, Frédéric; Rayssiguier, Romy; Captier, Guillaume; Faure, Jean-Michel; Dumont, Coralie

doi:10.1111/aogs.13418

Cited by 17 publications

(21 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The methodological quality of this study is strengthened by the fact that the data collection, extraction, and synthesis were performed separately by two researchers. Also, the broad Full-text articles excluded, with reasons (n = 11) -Sensitivity/specificity not calculable [15,18] -Design is a review [46,48] -Other language [38,39] inclusion criteria used in this study, without additional search filters, contribute to the discovery of almost all available studies [23]. Furthermore, the power and precision of this study were increased, because a meta-analysis was performed [10].…”

Section: Discussionmentioning

confidence: 99%

“…Just as interest grows in diagnosing CP using prenatal MRI, improving prenatal diagnosis of CP through US techniques also receives attention [15,30]. For example, using clinical markers derived from 2D-and 3D sonography is suggested to improve correct diagnosis of CP in the first trimester [30] and a scoring system has been developed to help sonographers to correctly identify CP [15]. To summary all US innovations is beyond the scope of this study, but is recommended to be further explored in future research.…”

Section: Discussionmentioning

confidence: 99%

“…A study including 29 couples reported that 96% of the parents considered prenatal counselling as beneficial [38]. Early detection of orofacial clefts can also enable organization of the delivery in a tertiary center [15] and lead to fewer medical complications [20].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Diagnostic accuracy of fetal MRI to detect cleft palate: a meta-analysis

et al. 2019

View full text Add to dashboard Cite

This systematic review aims to determine the diagnostic accuracy of fetal MRI for detecting cleft palate in fetuses at risk for orofacial clefts. Pubmed, Embase, and CINAHL were searched systematically. A diagnostic study was included if it performed MRI (index test) and postnatal examination (reference test) in fetuses at risk for orofacial clefts. Methodological quality was assessed using the QUADAS-2. A meta-analysis was performed with a random-effects model, calculating the pooled sensitivity, specificity, and area under the curve. The search resulted in eight studies (334 fetuses) to be included: four prospective and four retrospective studies. The applicability concern was low. There was, however, a risk of selection and information bias. All studies showed that MRI well predicted the chance of cleft palate. The sensitivity results were homogeneous, but heterogeneity was assumed regarding the specificity estimate (Cochrane's Q test: p = 0.00). The pooled sensitivity was 0.97 (95% CI 0.93-0.99); the pooled specificity was 0.94 (0.89-0.97). The area under the curve was 0.98 (95% CI 0.98-0.99). Conclusion: This meta-analysis shows that MRI has an excellent sensitivity and good to excellent specificity for diagnosing cleft palate in fetuses at risk for orofacial clefts. Future research should assess applicability for clinical care. What is Known: • Using ultrasound for prenatal detection of cleft palate leads to misdiagnosis frequently. • MRI could potentially improve the prenatal detection rate of cleft palate. What is New: • Eight studies describe the diagnostic accuracy of MRI for detecting cleft palate. • Combined results show excellent sensitivity and good to excellent specificity.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Diagnostic accuracy of fetal MRI to detect cleft palate: a meta-analysis

et al. 2019

View full text Add to dashboard Cite

show abstract

“…The axial transverse view of palate had been extensively studied but most often shadowing from the alveolar ridge hinders visualization of secondary palate. [31][32][33][34] In first trimester, the maxillary gap serves as an efficient marker to detect palatine cleft and this sign when used along with PMD described recently serves as a clue to identify isolated cleft of secondary palate 11,12 . The retronasal triangle does not serve to identify isolated cleft of secondary palate and clefts confined to the premaxilla alone 10 .…”

Section: Rotten Et Al In 2004 Observed That the Presence Of Midline Ementioning

confidence: 99%

Absent ‘superimposed‐line’ sign: novel marker in early diagnosis of cleft of fetal secondary palate

Lakshmy

Rose

Masilamani

et al. 2020

Ultrasound in Obstet & Gyne

View full text Add to dashboard Cite

What are the novel findings of this work? We describe a new sonographic sign, the 'superimposedline' sign, for evaluation of the fetal secondary palate in early gestation on two-dimensional imaging of the vomeromaxillary junction in the midsagittal view. What are the clinical implications of this work? Inclusion of this sign during the routine nuchal translucency scan should improve screening and early detection of secondary palatine clefts. This sign also facilitates evaluation of cleft extension into the secondary palate when a defect in the premaxilla is identified.

show abstract

“…To define the best 2D view, which permitted the best 3D volume acquisition plane when an abnormal shape of the horizontal plate of the secondary palate was seen, the use of a quality score is required. Because the prenatal ultrasound semiology of cleft palate using this ATV was unknown, we decided to define a 'modified ultrasound 2D quality score' of the images of the fetal palate based on our previously 'ultrasound 2D quality score' of the fetal hard palate published by Fuchs et al 22 Indeed, our original score (from 0 to 6 points) attributed 2 points for the normal visualization of What's already known about this topic?…”

mentioning

confidence: 99%

Prenatal ultrasound diagnosis of cleft palate without cleft lip, the new ultrasound semiology

Faure

Mousty²,

Bigorre

et al. 2020

Prenatal Diagnosis

Self Cite

View full text Add to dashboard Cite

Objectives: The aim of this study was to define the prenatal ultrasound semiology of cleft palate without cleft lip using 3D visualization of the fetal palate. Methods: A prospective longitudinal study was performed in our University Hospital Center from 2011 to 2018. The fetal secondary palate was studied in 3D, starting with 2D axial transverse ultrasound view. We defined a cleft palate as a disruption of the horizontal plate of the palatine bone of the secondary palate. Prenatal findings were correlated to anatomic postnatal examinations performed by a paediatric plastic surgeon. Results: Forty-three cases of cleft palate without cleft lip were prenatally diagnosed, of whom 34 were associated with malformations. We defined four types of disruptive appearances: isolated nonvisualization of the posterior nasal spine; partialdisruption or cleft velum; complete disappearance or V-shaped cleft palate; and complete disappearance or U-shaped cleft palate. The adjusted kappa coefficient, between prenatal and postnatal evaluation, was 0.88 (95% CI: 0.79-0.97), corresponding to an excellent agreement. Conclusions: Using a strictly axial transverse ultrasound view, visualization of the secondary fetal palate enables to diagnose a cleft palate without cleft lip. This method offers a prenatal anatomic classification of cleft palate with a high level of concordance to postnatal findings.

show abstract

A score‐based method for quality control of fetal hard palate assessment during routine second‐trimester ultrasound examination

Abstract: This simple image scoring system for the fetal palate is easy, has excellent inter- and intra-reviewer reproducibility and could also help sonographers to correctly identify the palate structure.

Cited by 17 publications

References 34 publications

Diagnostic accuracy of fetal MRI to detect cleft palate: a meta-analysis

Diagnostic accuracy of fetal MRI to detect cleft palate: a meta-analysis

Absent ‘superimposed‐line’ sign: novel marker in early diagnosis of cleft of fetal secondary palate

Prenatal ultrasound diagnosis of cleft palate without cleft lip, the new ultrasound semiology

Contact Info

Product

Resources

About